Table S1: Summary of physical activity behavior change interventions
Study & Focus
/ Context/setting and sample characteristics / Intervention characteristics & control condition / Study design & evaluation Method / Outcome measures / Key Findings /Booth (2008) [19]
Australia
Other behaviors targeted: NU & weight / Setting: community
Recruitment: local and city newspapers, flyers in local community centers, libraries & health centers
Eligibility/inclusion criteria: 24.5 ≤ BMI ≤ 37; Internet access
Exclusion criteria: <18y, pregnant/lactating, receiving medications for Type 1/2 DM
Participants (baseline): 73 adults
Retention rate: 73%
Final sample characteristics: 79%F; 81% Anglo-Australian; 51% tertiary education / G1: CT Internet exercise program
G2: CT Internet diet + exercise program (as per G1 plus diet program & minimum 3 diet emails)
Tailoring: current recommendations, previously set goals
Theory: Goal-setting theory
Frequency: multiple exposure (weekly at minimum)
Duration: 12 weeks
Incentives offered: No / Design: Pilot randomized trial; randomized by individual; groups comparable at baseline (demographics & OM)
Follow-up: 12 weeks (PT) / Primary OM: anthropometric measurements (weight, height, waist circumference), frequency & intensity of PA in previous week, average daily no. steps
Instrument: PA questionnaire (based on Active Australia survey), pedometer.
Validated: Yes / Behavior: Significant increase in no. daily steps taken from baseline to follow-up, but no difference between groups; No significant differences in other self-reported PA
WR: Significant fall in waist circumference & BMI in both groups, no differences between groups; 21% participants moved from having waist circumference in very high risk category to a lower risk category; Significant association between step change & waist circumference change from week 1 to 12 for both groups
Cook (2007) [20]
United States
Other behaviors targeted: NU / Setting: workplace
Recruitment: email letter, online flyer, posters
Eligibility/Inclusion criteria: workplace employees (n=~5000) in 3 offices of a human resources co.
Exclusion criteria: NR
Participation rate: 10%
Participants (baseline): 480 adults (G1= 247; G2 = 233)
Retention rate: 87% (G1=85%; G2 = 87%)
Final sample characteristics: 72%F, 81% White; 95% college or higher education; mean age: G1=41.99y; G2 = 42.03y / G1: CT Internet ‘Health Connection’ program (graphics, audio & video)
G2: Generic print materials on same topics (5 commercially available booklets)
Tailoring: stage of change, current recommendations
Theory: SCT & TTM, health behavior change theory
Frequency: multiple exposure
Duration: 3 months
Incentives offered: Yes / Design: RCT; randomized by individual; online questionnaire; baseline groups equivalent (demographics & OM)
Follow-up: 3 months (PT) / OM: frequency of PA in past week; motivation to improve exercise; behavioral intentions towards exercise; exercise self-efficacy; stage of change for weight and exercise; weight; process evaluation measures
Instrument: online health survey consisting of many measurement items
Validated: Majority have been pre-tested & validated, validation of some UK. / Behavior: No difference between two groups in increasing PA; both groups improved significantly from pre- to post-test for PA OM;
WR: No significant differential change in weight between two groups.
Hurling (2007) [21]
United Kingdom / Setting: Community
Recruitment: NR, occurred through market research recruitment agency
Eligibility/Inclusion criteria: living within 50km study centre; 30-55 yrs; BMI 19-30; not vigorously active; not taking regular prescription medication; Internet & email access; mobile phone user; not employed by Unilever.
Exclusion criteria: heart condition, pain in chest when exercising, joint problem that might be aggravated by exercise
Participants (baseline): 77 adults(G1= 47; G2= 30)
Retention rate: 96%
Baseline sample characteristics: 66%F; mean age 40.4y (SD=7.6); mean BMI 26.3 (SD=3.4) / G1: CT intervention delivered through Internet, email and mobile phone
G2: verbal advice on recommended PA levels on one centre visit
Tailoring: peer behavior, previously set goals, current recommendations, perceived barriers
Theory: social psychological theories (social comparison, decisional balance, elaboration likelihood, Goal)
Frequency: multiple exposure (weekly at minimum)
Duration: 9 weeks
Incentives offered: Yes / Design: RCT; randomized by individual (after being stratified by age, gender, BMI); groups comparable at baseline (demographics & OM); anthropometric measures at clinic; Participants instructed in use of system & issued a wrist-worn accelerometer & blue tooth compatible mobile phone in one centre visit; Baseline data = 3 weeks worth PA data; Intention to treat analysis conducted.
Follow-up: 10 weeks (PT) / Primary OM: change in moderate PA; weight change, % body fat, resting blood pressure;
Instrument: longer version of IPAQ & Bluetooth connected wrist-worn accelerometer
Validated: Yes
Other OM: Motivation, skills used to increase PA
Instrument: Exercise ‘Skills and Knowledge Questionnaire’ / Behavior: Higher level of MI-PA in G1 than G2: G1 increased on average 2h18min MI-PA/week over G2; Reduction in weekly hrs spent sitting: significant difference between G1 & G2;
WR: Significant difference between G1 & G2 for change in % body fat
Mediators: G1 reported a significantly greater increase over baseline than G2 for perceived control and intention to exercise; G1 rated themselves as more satisfied with their fitness & well-being; and had significantly higher sense of internal control and external control over exercise than G2
Marcus (2007) [22]
United States / Setting: community
Recruitment: newspaper advertisements, local hospital worksite’s Intranet, email and employee pay stubs
Eligibility/inclusion criteria: healthy, age 18-65y, under active (defined as participating in ≤ 90 min/wk moderate or vigorous PA);
Exclusion criteria: BMI>35, certain medical, psychiatric conditions & medication, >3 alcoholic drinks/day on ≥5 days/wk
Participants (baseline): 239 sedentary adults (G1 = 80, G2 = 81, G3 = 78)
Retention rate: 6 months 91% (G1 = 94%, G2 = 88%, G3 = 92%); 12 months 86% (G1 = 88%, G2 = 82%, G3 = 89%)
Sample characteristics (baseline): 82%F; 90% Caucasian; mean age 44.5y, 71% college education or above / G1: CT intervention delivered via telephone
G2: CT intervention delivered through print
G3: wait-list control
Tailoring: stage of change
Theory: TTM, SCT
Frequency: 14 contacts (more frequent at beginning of study i.e. weekly in 1st month) each call approximately 13 min
Duration: 12 months
Incentives offered: Yes / Design: RCT; randomized by individual; groups comparable at baseline (demographics & OM); Participants completed physical activity log & questionnaire monthly; Interviewer-administered; Intention to treat approach taken for analysis
Follow-up: 6 & 12 months (PT) / Primary OM: PA participation
Instrument: 7-day Physical Activity Recall interview
Validated: Yes
Other OM: anthropometric measurements, Functional capacity (estimated VO2) at maximal heart rate, treadmill duration, stages of change
Other instruments: exercise stress test, psychosocial questionnaires; A sub-sample (30%) also wore an Actigraph to validate self-reported PA outcome findings
Validated: Yes / Overall individually tailored print & telephone interventions efficacious in PA adoption, print more so for PA maintenance
6 months:
Behavior: G1 & G2 significantly greater increase than G3 participants in PA mins/wk but no difference between G2 & G3; G1 & G2 significantly more likely than G3 to achieve 150min PA/wk
Mediators: Significant between-group differences in behavioral processes, cognitive processes, decisional balance & self-efficacy; G1 & G2 more likely to report increase than G3
12 months:
Behavior: G2 significantly greater increases in PA min/wk than G3, G2 significantly better than G1 (G2 increased, G1 decreased); G2 participants significantly more likely to achieve 150min PA/wk than G3
Exercise stress test: no significant differences at 6 or 12 months
Mediators: as per 6 months; self-efficacy increased for G2 participants and declined for G1 participants
Spittaels (2007) [23]
Belgium / Setting: workplace
Recruitment: email, posters, internal newsletters.
Response rate: 7%
Eligibility/Inclusion criteria: Age 25-55y, Internet access.
Exclusion criteria: history CVD
Participants (baseline): 526 adults
Retention rate: 72% (G1= 66%; G2= 69%; G3=1 79%)
Baseline sample characteristics: 69.4%M; mean age 39.5y; 61.7% college or uni degree / G1: CT intervention via Internet & stage-based reinforcement e-mails
G2: CT intervention via Internet
G3: non-tailored Internet intervention
Tailoring: current recommendations, stage of change, self-efficacy, attitudes, intentions
Theory: TTM & Theory of Planned Behavior
Frequency: multiple exposure (at minimum 5 emails)
Duration: 6 months (emails for 8 week period)
Incentives offered: Yes / Design: RCT; baseline groups comparable (demographics & OM); paper questionnaires
Follow-up: 6 months (post-baseline) / Primary OM: frequency & duration of PA (at work, as transportation, for household chores, during leisure time) & daily sitting time); additional objective WR assessment in sub sample (1 worksite, n=57): height, weight, body fatness, blood pressure, heart rate and PA accelerometer
Instrument: Long usual week version of the IPAQ
Validated: Yes
Other OM: process evaluation measures; additional objective assessment (height, weight, body fatness, blood pressure, heart rate and PA accelerometer) in 1 of the 6 worksites (n = 57) / Behavior (total sample): no significant difference between groups however all 3 groups reported significant increase in PA;
WR (for sub sample, n=57): significant time x group interaction for % body fat – greater decline in % body fat in G1 compared with other 2 groups
-significant decrease in BMI, fat %, diastolic blood
Spittaels (2007) [24]
Belgium / Setting: Community
Recruitment: distributed brochures (school)
Eligibility/Inclusion criteria: 20-55 yrs, Internet access.
Exclusion criteria: history of CVD
Participants (baseline): 434 parents and staff of 14 primary & secondary schools (G1 = 173, G2 = 129, G3 = 132)
Retention rate: 66%
Baseline sample characteristics: 66%F; mean age 41.4y (SD = 5.6); mean BMI 24.6 (SD = 3.6), 66.8% higher education, 86.1% employed
Final sample characteristics:
Men, participants with higher BMI & dropouts significantly higher in intervention groups (40%) than control group (21%) / G1: CT & non-tailored Internet intervention; 7 non-tailored emails, repeated tailored feedback possibility at 3 months
G2: CT & non-tailored Internet intervention (single exposure)
G3: wait list control
Tailoring: current recommendations, stage of change, self-efficacy, attitudes, intentions
Theory: TTM & the Theory of Planned Behavior
Frequency: multiple exposure (minimum 7)
Duration: 6 months
Incentives offered: Yes / Design: RCT; potential participants randomized by school region; Both intent-to-treat and retained sample analysis conducted.
Follow-up: 6 months (PT). / Primary OM: frequency & duration of PA (at work, as transportation, for household chores, during leisure time) & daily sitting time;
Instrument: Long usual week version of the IPAQ
Validated: Yes
Other OM: Process evaluation measures / Behavior: Participants in both groups 1 & 2 reported a significant increase in PA level and decrease in time spent sitting compared to G3; Significant time by group effects were found for active transportation, PA in leisure time and time spent sitting on a weekday.
Intention to treat analysis: intervention resulted in a significant increase of 10% of participants that met PA recommendations in G1 compared to non-significant increases of 5% (G2) & 4% (G3).
Steele (2007) [25]
Australia / Setting: community
Recruitment: local newspaper advertisements
Eligibility/Inclusion criteria: ≥18y; functionally mobile ≥10 mins; inactive; Internet access; signed informed consent.
Exclusion criteria: No medical clearance from participant’s general practitioner if identified as having cardiac & other health problems at screening
Participants (baseline): 192 inactive adults (G1 =65, G2 = 65, G3 = 62).
Retention rate: PT 83%; PI follow-up 77% (G1=80%; G2=72%; G3=77%)
Sample characteristics (baseline): 83%F; mean age 38.7+/-12y; mean BMI 32.1 +/-7.5 / G1: Face-to-face intervention with trained program facilitator
G2: CT Internet intervention, weekly emails & opportunity to attend 2 (1hr) face-to-face sessions
G3: CT Internet intervention & weekly emails
G2 & G3 had access to on-line Health-eSteps rep, Nutritionist & Exercise Physiologist via email
Tailoring: unclear, noted individualized & personally relevant
Theory: SCT & self-management framework.
Frequency: multiple exposures (minimum weekly)
Duration: 12 weeks
Incentives offered: Yes / Design: RCT; randomized by individual; groups comparable at baseline (demographics & primary OM); face-to-face contact for data collection; each participant provided with pedometer; intention-to-treat analysis conducted; testing of statistical equivalency conducted
Follow-up: 5 months PI / Primary OM: frequency & duration of PA
Instrument: Active Australia questionnaire
Validated: Yes
Other OM: height, weight PA self-efficacy, Internet self efficacy; social support for PA, process measures, pedometer usage / Behavior: Mean minutes PA increased by 270 min (G1), 177 min (G2) & 170 min (G3); no group by time interaction; All groups significantly increased PA from baseline to 5-month follow-up but G3 decreased between 2 & 5 months.
Vandelanotte (2007 & 2005) [26,27]
Belgium
Other behaviors targeted: NU / Setting: University computer laboratory, controlled
Recruitment: local media, posters, leaflets and email. Eligibility/Inclusion criteria: Age 20-60y
Exclusion criteria: medical complaints related to PA or fat intake.
Participants (baseline): 1023 adults
Retention rate: 6 months 75%; PI follow-up38%
Final sample characteristics (6m): 65%F; mean age 39.1Y+/-9.6; 70% higher education; 86% employed; mean BMI 24.5 +/-4.1; Men & younger participants more likely to drop out / G1-G3 received interactive CT intervention delivered through desktop computer application
G1: tailored PA and fat intake interventions simultaneously
G2: tailored PA intervention at baseline and tailored fat intake intervention 3 months later
G3: tailored fat intake intervention at baseline and tailored PA intervention 3 months later
G4: wait-list control; received tailored interventions at 6 months.
Tailoring: current recommendations, stage of change, self-efficacy, attitudes, intentions
Theory: Theory of Planned Behavior & TTM
Frequency: single-exposure
Duration: 6 months
Incentives offered: Yes / Design: RCT; randomized by individual; mail questionnaires.
Follow-up: 6 months (PT), 2 years post-baseline (follow-up study in which control group omitted from analysis as were wait list) / 6-months:
OM: frequency & duration of PA (at work, as transportation, for household chores, during leisure time) & daily sitting time; Instrument: Long self-administered version of the IPAQ
Validated: Yes
2 year follow-up:
OM: total PA; mod+high intensity PA (Groups 1 & 2 only included for PA analysis, n=257); / 6 months: Groups 1-3 had significantly higher PA scores (total PA) compared to G4; There was no significant difference between the sequential and simultaneous intervention groups for PA
2 years (no control group):
No differences in PA change between Groups 1 & 2 but strong time effects for both total PA & mod+high intensity PA for total group
Winett (2007) [28]
United States
Other behaviors targeted: NU / Setting: churches